Prenatal Patient and Parent of Minor Consent

Evaluation of the Text4baby Program

Consent

Prenatal Patient and Parent of Minor Consent

OMB: 0915-0347

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Health Resources and Services Administration’s Evaluation of the Text4baby Program:

Burden associated with Patient Consent



Health center staff will be providing prenatal and post natal patients with informed consent forms to read and sign before participating in the consumer survey and focus groups. The burden below accounts for the time taken for health center staff to distribute consent forms to respondents, and prenatal patients and parents of minors to read and sign the consent forms.



The estimated annualized burden for these activities is as follows:

Instrument

Person Incurring Burden

Number of Respondents

Responses per Respondent

Total Responses

Hours per Response

Total Burden Hours

Prenatal Patient Consent

Health Center Staff

1630

1

1630

0.08

130

Prenatal Patient

1630

1

1630

0.08

130

Parent-of-Minor Consent

Health Center Staff

195

1

195

0.25

49

Parent of Minor

195

1

195

0.08

16

Total






325





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